ABSTRACT
Any violation of the peritoneal cavity causes a cascade of physiologic events, some of which may result in the inhibition of gastrointestinal function. Physical manipulation of the viscera further impairs gut motility as the result of inhibition of the splanchnic sympathetic reflex and stimulation of local inflammatory mediators (1). Although gross motor function of the small bowel is commonly observed during laparotomy, such motility may not be a part of effective, coordinated peristalsis (2). Depending on the site and degree of visceral manipulation, the underlying disease process, and patient characteristics, paralytic ileus may last from hours to days. Ileus has been recognized as an inevitable consequence of intestinal surgery. Postoperative ileus is further exacerbated by
the use of opioids for analgesia. The high density of m-opioid receptors throughout the gastrointestinal tract as the result of endogenous release and exogenous administration of opioids results in prolonged transit time after surgical stress (3-5).
